NPI | 1770630311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NJ 4616) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: AL 1486) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2010-06-13 |